Who is Leaving the Emergency Medical Services Workforce?

Objectives: To explore sociodemographic characteristics, work characteristics, and job movements among the emergency medical services (EMS) workforce.

Design: This cross-sectional retrospective study examined changes in the size and characteristics of the EMS workforce overall and among “leavers” (those who left the workforce) in the pre-pandemic (2018-2020) and post-pandemic (2021-2023) periods.

Settings: United States labor force.

Participants: Respondents to the 2018-2023 Current Population Survey Annual Social and Economic Supplement.

Main outcome measure: Whether an individual stayed in or left an EMS occupation.

Results: Among an annual average of 247 410 working EMS clinicians over the 6-year period, descriptive analyses showed an increase in leaver rates from 16.0% to 23.2%. American Indian/Alaska Native/Native Hawaiian/Pacific Islander, Asian, and Black EMS clinicians had significantly higher leaver rates than mixed race or White groups, as did clinicians who were not US-born citizens. In the regression analysis, race was the only significant predictor of leaving such that Asian and Black clinicians were significantly more likely to leave EMS jobs than clinicians of other racial backgrounds. A significantly increased number of clinicians exited the workforce altogether, and those that remained in the workforce in non-EMS occupations shifted from working in hospital or public administration settings to working in other health sectors.

Conclusions: The study shows a high rate of leavers in the EMS workforce with higher rates of leaving among diverse clinicians throughout the study period. Policies designed to mitigate turnover in the EMS workforce are needed, particularly those that support the retention of diverse EMS clinicians.